Unrecognized Dermatomycoses Treated With Topical Steroids

Abstract

ed in rare cases of ketoconazole (1%). With griseofulvin urticaria, photodermatitis, exacerbation of LE, FDE, angio-oedenia, erythema multiforme, serum sickness, TEN, have been reported. With flucytosine transient macular and urticaria] rashes have been seen. Adverse reactions of fluconazole are usually mild and include pruritus and exanthenias. However, rarely severe skin reaction have been described: erythema multiforme, StevensJohnson syndrome, TEN, FDE, angioedema, reversible alopecia. With itraconazole the most common cutaneous events have been reported pruritus and niaculo-papular eruption. AGEP, urticaria, photo-allergic reaction were also seen on rare occasions. The cutaneous adverse effects reported with terbinafine include: rash, pruritus, urticaria, erythema niultiforme, TEN, FDE, AGEP With increasing use of oral antifungal agents it is likely that the spectrum of adverse reactions will be recorded with greater frequency.During the last decades, the incidence of fungal infections has increased dramatically. Deep-seated mycoses are creating serious problems for clinicians working with certain populations of patients, such as those with cancer, the immunoconipromised, and physiologically conipromised. A study of fungi isolated for identification from deep fungal infections was carried out in tlie section of hledical hlycology, Pasteur Institute of IRAN from April 1994 to March 1998. 777 samples were examined for deep fungal infections. Diagnosis was established by demonstration of fungi in direct and cultural examinations. In the present report fungi were isolated from 102 men and 100 women. 68 fungi were isolated (33.7%), in patients that they had one or more predisposing factors for disseminated fungal infections. 134 (66.3%) fungi were isolated in non-compromised patients. The most frequent isolate was Candida with 72.3%. In this study frequent predisposing factors in imniunocompromised hosts were hematologic malignancy, metabolic acidosis, hyperglyceniia and organ transplant at ion.Fungal respiratory infections are being recognized with increasing frequency in parallel with an expanding population of immunocompromised patients. From 347 lower respiratory tract specimens, we isolated and identified 127 fungi by direct examination and culture as fol-lows: Cnndida albicans, Candida sp., Aspergillus Qmigntics, Aspergillusjlaow, Aspergillus nigeg Aspergillus sp., Fusariuin sp., Clndosporium bantianuni, Pseudallescheria bcydii, and Actinoiiyces sp. In this study we isolated 54.3% of fungi in patients with one or more predisposing factors for fungal diseases. Summary: Fungal sinus infections are being recognizedwith increasing frequency. We report one case with rhinocerebral and chest phaeohyphomycosis infection caused by Clndosporium bantianuin in an 18 year old man with Wegener's granuloniatosis. The diagnosis was established by histopathological appearance, direct exaniination, culture and computerized tomography (CT) scan.This case was successfully treated by a combination of surgery and amphotericin B....